This paper evaluates the arguments against physician assisted suicide which contend that it violates the integrity of medicine and the physician – patient relation; i.e., that it contradicts the goal of seeking health and healing, violates an absolute prohibition against killing, and undermines the patient’s trust in the physician. These arguments against physician assisted suicide 1) misuse notions of teleology and teleological explanation; 2) rely on inappropriate notions of “ideal medicine”, for which death is a defeat; 3) turn on a highly selective reading fo the Hippocratic tradition; and 4) are unacceptably paternalistic. (19 refs)